Coordinated Care Programs

Coordinated Care Programs are programs that provide a package of service designed to meet an individual’s unique needs. Coordinated care programs include care coordination services that provide assistance with care planning and connecting individuals to needed services and resources.

Home and Community-Based Waivers

Acquired Brain Injury – Non-Residential Waiver – This program helps people eligible for MassHealth with acquired brain injury (ABI) to move back to the community from a facility setting and receive community-based services. The program provides services to individuals who can move to their own home or apartment or to the home of someone else. This can include participants receiving Adult Foster Care services. The program is operated by the Massachusetts Rehabilitation Commission.

Acquired Brain Injury- Residential Waiver – This program helps people eligible for MassHealth with acquired brain injury (ABI) to move back to the community from a facility setting and receive community-based services. The program provides services to individuals who need supervision and staff support 24 hours a day, seven days a week in a residential setting. Residential support services can include living in a group home with up to 4 individuals, an assisted living residence, or shared living with 24 hour supports. The program is operated by the Department of Developmental Services.

Adult Supports Waiver – This program provides community support for people eligible for MassHealth with an intellectual disability. It supports people who can live in their family home, in the home of someone else, or their own home and who do not need supervision 24 hours a day, seven days a week. The Adult Supports Waiver is operated by the Department of Developmental Services.

Children’s Autism Spectrum Disorders Waiver - This program provides intensive in-home and other services to children with autism covered by MassHealth. The Children’s Autism Waiver is operated by the Department of Developmental Services.

Community Living Waiver – This program provides supportive services to people eligible for MassHealth with an intellectual disability who can live in their family home, in the home of someone else, or their own home, and who do not need supervision 24 hours a day, seven days a week. The program is operated by the Department of Developmental Services.

Frail Elder Waiver - This program helps people age 60 and older covered by MassHealth to receive health care and support services in their homes. It is for people who would meet the criteria for nursing home care but prefer to live in the community. The program supports elders through services to assist with self-care and everyday tasks. The Frail Elder Waiver is operated by the Executive Office of Elder Affairs Home Care Program.

Intensive Supports Waiver – This program provides flexible and necessary supports and services to adults eligible for MassHealth with an intellectual disability who require supervision and access to support 24 hours a day, 7 days per week. People in this program may reside in out-of-home residential settings or in their family home with a comprehensive array of supports. The Intensive Supports Waiver is operated by the Department of Developmental Services.

Money Follow the Person (MFP) Residential Supports Waiver - This program helps adults eligible for MassHealth to move back to the community from a facility setting and receive community-based services. Qualified community residences include supervision and staffing 24 hours a day, seven days a week in a home with up to 4 residents. This program is operated by the Department of Developmental Services.

Money Follow the Person (MFP) Community Living Waiver - This program helps adults eligible for MassHealth move back to the community from a facility setting to live in a qualified residence and receive community-based services. This program is operated by the Massachusetts Rehabilitation Commission.

Traumatic Brain Injury (TBI) Waiver – This program provides community services to people eligible for MassHealth with a traumatic brain injury who meet the criteria for nursing facility or hospital care but prefer to live in the community. The program provides individuals with a traumatic brain injury the support services they need to live safely in their homes and the community. The TBI Waiver is operated by the Massachusetts Rehabilitation Commission.

Integrated Care Programs

One Care is an integrated care option for people with disabilities (eligible for both Medicare and MassHealth) offering the full set of services provided by both MassHealth and Medicare through a One Care plan. One Care plans are health plans that cover Medicare and MassHealth services, including Medicare Part D drug benefits. One Care plans also offer a Care Coordinator to help put together a Personal Care Plan that addresses a person’s physical, behavioral health and long-term services and supports needs. The Personal Care Plan could include additional community-based behavioral health services and other community support services.

Program of All Inclusive Care for the Elderly (PACE) is administered by MassHealth and Medicare to provide a wide range of medical, social, recreational, and wellness services to eligible participants ages 55 and older. The goal of PACE is to allow participants to live safely in their homes instead of in nursing facilities.

Senior Care Options (SCO) is a comprehensive health plan for elders ages 65 and older. SCO covers all the services normally paid for by Medicare and MassHealth and also includes care coordination. SCO health plans provide services through a network of providers who provide a person with health services and social service support.

A Service of the Massachusetts Executive Office of Health and Human Services.